South Carolina

South Carolina received approximately $200.03 million for the first budget period of the five-year Rural Health Transformation Program, its share of the federal $50 billion program, with additional annual awards expected in each funding year. The state is deploying the money largely through a subrecipient grant model organized around five core initiatives.

The South Carolina Department of Health and Human Services (SCDHHS) administers the program, branded South Carolina Rural Health Transformation, in coordination with the South Carolina Office of Rural Health. SCDHHS has contracted BDO Government Services LLC to conduct quarterly audits, monitor subrecipients, and manage CMS reporting, and has partnered with the South Carolina Research Authority (SCRA) to run the Tech Catalyst Fund. Program contact: grants@scdhhs.gov; hub at scorh.net.

South Carolina has organized its transformation strategy into five core initiatives: Connections to Care (digital infrastructure — EHRs, remote patient monitoring, telehealth, a statewide resource database), Leveling Up (scaling chronic-disease and pediatric-care programs statewide), Wellness Within Reach (mobile health units, crisis-response teams, pop-up clinics), Shoring Up to Sustainability (workforce recruitment and retention, facility upgrades, provider training), and the Tech Catalyst Fund (non-dilutive seed funding for rural health-tech startups). Priority tags include digital regionalization, maternal care, hubs, EMS stabilization, CHW expansion, telehealth, and rural residency.

• Connections to Care (SCDHHS-26-001) — $75M Year 1: Health IT modernization ($100K–$2M, or $5M–$10M for full EHR replacement) and remote patient monitoring / assistive technology ($250K–$5M). No more than 5% of the state award may go toward replacing an existing HITECH-certified EHR.
• Leveling Up (SCDHHS-26-002) — $27M Year 1: chronic-disease program expansion ($100K–$5M per award).
• Wellness Within Reach (SCDHHS-26-003) — $27.7M Year 1.
• Shoring Up to Sustainability — workforce, facilities and training.
• Tech Catalyst Fund — $25M over five years (about $5M and 4–6 subrecipients in Year 1, capped at $3M per company).

The full breakdown is in South Carolina's updated budget narrative.

For the first budget period SCDHHS released four concurrent Requests for Applications corresponding to four of its five initiatives — Connections to Care (SCDHHS-26-001), Leveling Up (SCDHHS-26-002), Wellness Within Reach (SCDHHS-26-003), and Shoring Up to Sustainability — posted in early April 2026. The fifth initiative, the Tech Catalyst Fund, runs on a separate track via SCRA; its first application window closed June 26, with about $5M expected to reach 4–6 startup subrecipients. SCDHHS is also separately procuring a consultant for a statewide rural needs assessment and dual-eligible managed-care transition. The dispatch list below carries the running record.

The four initiative RFPs opened in early April 2026 and the Tech Catalyst Fund's first window closed June 26, 2026. With that first cycle now largely past, new application windows and the next Tech Catalyst Fund stage surface first in the dated dispatches below and on the SCDHHS grants page. Subscribe to the Office of Rural Health updates to catch new postings.

The Rural Health Transformation Program was created by Section 71401 of the One Big Beautiful Bill Act (2025) and is administered federally by CMS. South Carolina administers its award through SCDHHS under its CMS-approved plan and updated budget narrative, using a competitive subrecipient grant model with BDO Government Services LLC monitoring overall program compliance.

Eligibility runs on two tracks. Direct-to-state contracts go out as competitive RFAs/RFPs where firms bid as prime contractors (and, separately, a state consultant for the rural needs assessment). Subawards flow to rural providers — rural hospitals, clinics, FQHCs, behavioral health and EMS organizations — where technology vendors and consultants most often engage as subcontractors or implementation partners. The Tech Catalyst Fund is the exception: it pays health-tech startups directly as non-dilutive capital (capped at $3M per company), administered through SCRA.

Track opportunities on the SCDHHS grants portal and the RHT hub, subscribe to Office of Rural Health updates, and direct questions to grants@scdhhs.gov.